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RVU requirements
There are a lot of threads on average RVUs and how they might vary by practice type, but do your groups have RVU requirements/ goals to reach? Is there a threshold below which someone is given a talking to / punished or let go?
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39 Replies
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50th percentile AAARAD is the mendoza line in my practice (academic lite). If a rad doesn’t perform above that level over a 6 month interval the administration knows and the chair/section head will have a chat.
If it persists, that person will get let go or have their salary adjusted down.-
For some reason it seems strange to me to let someone go because they are below the 50th percentile. Am I missing something? What if they’re 45th percentile? Everyone in your group is above average?
Again, just curious.-
Quote from Teedevil
For some reason it seems strange to me to let someone go because they are below the 50th percentile. Am I missing something? What if they’re 45th percentile? Everyone in your group is above average?
Again, just curious.
It is a little odd but I suppose it makes sense if they are paying significantly above the 50th percentile.-
AAARAD numbers are proprietary so I have never seen a full list. They are also academic-practice-specific and subspecialty specific so chest and neuro will have different benchmark RVU numbers.
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Quote from Teedevil
For some reason it seems strange to me to let someone go because they are below the 50th percentile. Am I missing something? What if they’re 45th percentile?
Admin has drawn a hard line at 50th. If you’re 45th … work harder or get canned.
They’ll give 6 months to pick it up. And honestly, if you can’t get to 50th percentile on the academic numbers you are *really* slow.
Everyone in your group is above average?
Again, just curious.The average productivity ex-moonlighting in our group is around 73rd %-ile.
With moonlighting numbers included it’s mid 90s.
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there is also cFTE (Clinical fraction Full-Time Equivalent- time available for clinical activity after any adjustments for academic, research and administrative efforts. Clinical effort is based on track, research funding, and educational and administrative responsibilities.
Lots of gaming with this.-
I agree conceptually that anything below 50% as a cutoff is problematic. Thats half of all radiologists.
Lake Wobegon: Where the women are strong, the men are good looking, and all the children are above average.
But ~ 6500 would be about 5% in PP.
So its kind of semantic. Most anyone could make that.
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Any gauge as to what 50th percentile for PP would be? 10-12k?
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Quote from tracer
Any gauge as to what 50th percentile for PP would be? 10-12k?
Not based on data but I would guess around 12K…I do recall hearing that 17/18K is around 90th percentile or so but this was a few years back
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Pretty sure Daniel Corbett said his groups were more like 14k range for 50th percentile? Maybe his groups aren’t a random sampling but I would guess around there for PP.
Of course, if you’re in a sub specialized group primary mammo and neuro “50th percentile readers” should be higher than that with others lower to balance things around 14k.-
50 to 55 RVU per day. If you can’t reach that in an average day, you should work at the VA
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Quote from Sir Read Alot
50 to 55 RVU per day. If you can’t reach that in an average day, you should work at the VA
That’s not realistic for all practice settings. In PP sure but not at a tertiary care center. -
9800 wrvu is right near mgma median.
I assume Dergons practice uses academic and subspecialty benchmarks since harsh to can everyone below 9800
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Yes – we use AAARAD subspecialty, not MGMA
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Quote from lk
9800 wrvu is right near mgma median.
I assume Dergons practice uses academic and subspecialty benchmarks since harsh to can everyone below 9800
Nice to use academic and subspecialty benchmarks and operate as academic lite. Sounds like something out of the private equity playbook.
Game that system, game it! -
Is MGMA more applicable to all of radiology? 9800 seems manageable but that would probably depend a lot on case complexity and teaching responsibilities.
I also assume academics get less vacation so it would be more shifts + less RVU reqs = much less RVU/shift than PP? And less pay of course
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Dergs, your practice is academic right, not fully making sense to me
So you get rid of everyone below the mean of academic RVUs?
But if your practice is academic, wouldnt half of your faculty be fired?
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Quote from W24
Dergs, your practice is academic right, not fully making sense to me
So you get rid of everyone below the mean of academic RVUs?
But if your practice is academic, wouldnt half of your faculty be fired?
Sounds like they are pseudo academic but paid above the standard academic wages so expected to produce above the standard academic clinical workload. -
They need to be above the median nationally not among the group, so if peds median is 6k, a peds rads would need to get more that that
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Sounds like they are pseudo academic but paid above the standard academic wages so expected to produce above the standard academic clinical workload.
This.
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They need to be above the median nationally not among the group, so if peds median is 6k, a peds rads would need to get more than that
And this
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Seems to be some confusion in this thread.
“Average” and “minimum” are very different. There are many rads in PP 20k+ per year range, bringing up the average for the group. Currently I think at most places the average is 12-14k, maybe more. The minimum output before it starts to ruffle feathers is below that.
Also with regard to getting canned under a 50th percentile number, this of course only applies when the number is taken from a different group of rads, not your own group. No group can get rid of or even be upset with half the rads, someone has to be in the bottom half.
But if you are taking that # from a different sampling its totally reasonable to expect 90+% of your group to be over a 50th percentile benchmark. If you are academic-lite, paid better than average, have less research than average etc then you should read more than a national average in your own individual group.
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I dont remember wRVUs being used at all when I started practicing a few decades ago. I also remember the mgma numbers for wRVUs being a fraction of what they are now years ago. Somehow the work got done.
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The median wrvu on auntminnie board is 25k annually:)
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Quote from Radsoxfan
Also with regard to getting canned under a 50th percentile number, this of course only applies when the number is taken from a different group of rads, not your own group. No group can get rid of or even be upset with half the rads, someone has to be in the bottom half.
This, exactly.
still dont get using the AAARAD mean as your benchmark. As my college engineering professor used to say, POOMA. Pulled Out of my As*.
If it says proprietary, basically means pooma
But whatever, thats your system, it works for you -
In my group, several years ago, average bottom was around 10000 wvru, with higher around 12000. Our weekdays were busy, but not terrible. The weekends began to be unbearable volume wise and in terms of the shift length. The weekend work changed secondary to a variety of factors Im not going to get into. I now work at the VA, which of course has lower work requirements, more of a lifestyle choice, lower pay, etc.
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I’ve never been in a practice that printed wRVU #s. What is reasonable expectation for number of cases read for hospital-based private practice? Mixed modality including ER, IP, OP. What is an acceptable range of case load?
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Quote from drad123
there is also cFTE (Clinical fraction Full-Time Equivalent- time available for clinical activity after any adjustments for academic, research and administrative efforts. Clinical effort is based on track, research funding, and educational and administrative responsibilities.
Lots of gaming with this.
so there is the AAA(whatever) to go in place of Raw RVUs, then this cFTE thing, then in a group I know, they invented their own system that they have another name for. Essentially, they adjusted the RVUs to match what they thought, or wanted them to be.
So – when you get down to the bottom, it is all arbitrary. ALL ARBITRARY. Means nothing. I am sure there are practices where the leader is very busy with administrative stuff, and his clinical RVUs fall, making him look bad, so he institutes a system of arbitrary RVUs for administrative work. Can make them as large as he wants. Can easily outdo anyone in the group by assigning 25 RVUS for a particularly difficult Administrative meeting, plus an extra 10 for prep time and maybe 5 for schmooze time.This is all rather fascinating if you wind back the clock to the 80s and see what the academics from Boston were writing about the RVU system they were proposing to introduce. They would tell you this system was set up so that different physicians were paid for equivalent work. And they were saying that they would be able to define what amount of work a t-surgeon did that was equivalent to a certain amount of work a pediatric endocrinologist did. They sold this bogus idea to legislators and bureaucrats, not that it was a particularly resistant audience. No, they really wanted some sort of way to control medicine and make it look in some way valid. Actually, I believe that politicians, being experts in greed and human nature, understood full well and perhaps had as a goal, using this system to create vicious fights within medicine, and thereby make it so that physicians were incapable of working together to oppose them.
At the time I had this vision of the govt arranging all physicians in a circle and tossing a pile of money (which would grow smaller every year) into the middle of the circle, and simply saying, you guys fight it out. Blood ensued.
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so there is the AAA(whatever) to go in place of Raw RVUs, then this cFTE thing, then in a group I know, they invented their own system that they have another name for. Essentially, they adjusted the RVUs to match what they thought, or wanted them to be.
So – when you get down to the bottom, it is all arbitrary. ALL ARBITRARY. Means nothing. I am sure there are practices where the leader is very busy with administrative stuff, and his clinical RVUs fall, making him look bad, so he institutes a system of arbitrary RVUs for administrative work. Can make them as large as he wants. Can easily outdo anyone in the group by assigning 25 RVUS for a particularly difficult Administrative meeting, plus an extra 10 for prep time and maybe 5 for schmooze time.
These are *good* things for an academic practice.
If you can get to broad consensus agreement among the radiologists about what is valued in the practice then you have fewer discontent. As long as the process is democratic and transparent it can really help strengthen the group.
A cFTE accomodation rewards administrative and academic efforts in academic departments. That’s a good thing. (Full disclosure … I have 0.1 cFTE decrease as Section Chief)
And while my ground doesn’t do it, I commend groups that are able to successfully put in place internal RVU re-weighting. That helps gets *all* of the work done, as opposed to just the high RVU work.
Yes, it’s arbitrary … but the goal is to implement a system in which the incentives to rads align with the goals of the department and the system, gets the clinical work done, and allows the group to retain/recruit.
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Quote from dergon
And while my ground doesn’t do it, I commend groups that are able to successfully put in place internal RVU re-weighting. That helps gets *all* of the work done, as opposed to just the high RVU work.
There is another way to skin the cat. If you have somewhat fixed work assignments based on subspecialty and location, reviewing a year or two of billing data allows you to come up with a median production per shift for that seat. There are some slots that are inherently lower in RVU than others without being any less work. There are other shifts that are high production (I could kill it if I had a home mammo setup and someone loaded me a days worth of screeners to batch-read). If one member gets an unusual number of the former shifts vs. the latter, they look like slouch on paper. The way around it is to calculate median numbers per seat and build the expected RVU for a particular rad off that.
Oh, we also need to assign some daily RVU for Dr X the haptic oncologist having your cell number. That can easily add up to an hour of double reading and consults when he sees your name on the rad schedule.
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Quote from Phil Shaffer
So – when you get down to the bottom, it is all arbitrary. ALL ARBITRARY. Means nothing. I am sure there are practices where the leader is very busy with administrative stuff, and his clinical RVUs fall, making him look bad, so he institutes a system of arbitrary RVUs for administrative work. Can make them as large as he wants. Can easily outdo anyone in the group by assigning 25 RVUS for a particularly difficult Administrative meeting, plus an extra 10 for prep time and maybe 5 for schmooze time.
You could make it arbitrary. You could also figure out the median RVU a member of the group produces per hour. If someone has a admin meeting that is on the group calendar, they get credited that median wRVU/hr for whatever time they are in the meeting. You could make it more granular and calculate an assignment specific wRVU/hr, but that really adds to the complexity.
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Quote from dergon
For some reason it seems strange to me to let someone go because they are below the 50th percentile. Am I missing something? What if they’re 45th percentile?
Admin has drawn a hard line at 50th. If you’re 45th … work harder or get canned.
They’ll give 6 months to pick it up. And honestly, if you can’t get to 50th percentile on the academic numbers you are *really* slow.Unless the volume is finite. On my most recent academic job, it was literally impossible to make remotely the RVU targets with the volume provided. So RVU count is a piss poor measure of speed when you don’t even have the volume to make it.
Now that I am in PP, I have zero problems making and exceeding the targets provided.
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Quote from dergon
50th percentile AAARAD is the mendoza line in my practice (academic lite). If a rad doesn’t perform above that level over a 6 month interval the administration knows and the chair/section head will have a chat.
If it persists, that person will get let go or have their salary adjusted down.
What RVU number is that?
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Quote from keptinthedark3
Quote from dergon
50th percentile AAARAD is the mendoza line in my practice (academic lite). If a rad doesn’t perform above that level over a 6 month interval the administration knows and the chair/section head will have a chat.
If it persists, that person will get let go or have their salary adjusted down.
What RVU number is that?
Around 6500 without adjusting for cfte. Very low for pp standards.
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20/day
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I thought it was subspecialty specific? Also I am not familiar with AAARAD but I know a lot of the national metrics suffer from skewed data for people that are part time, have academic days, admin days, etc. Their yearly rvu numbers would be lower but when you look at their daily rvu and extrapolate as if they were a full time, full clinical employee they may produce the equivalent of 12k per year
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That is one way to do it, and I dont think the optimal way.
When someone is given the freedom every day to read a below average amount – meaning that there are others pulling his weight – such that over the course of the year, they can fly under the radar and end up with a productivity so low that they get kicked out of the group that is a problem with the system, not the radiologist.
The rotations and workflow should be set up such that everybody who just shows up and does what they are supposed to will never have trouble meeting the threshold. Ill give two extreme examples: if a group sets an RVU requirement that 25% of the interventional radiologists cannot meet without logging on after hours to read plain films, that is a flawed system. Another extreme example, in a good way, are assigned worklists. If someone shows up and reads what they are assigned every day and then, at the end of six months, they dont need meet the RVU threshold, it is obvious that it is not their fault.
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They are indeed sub-specialty specific.
Peds/Chest much lower than Neuro.
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